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IBC is making system and process changes that will affect the way we do
business with you. These changes will offer
greater capabilities, increased flexibility in benefit design, and enhanced
functionalities for an improved overall customer
experience.
Effective November 1, 2013, mom and baby inpatient hospital
claims must be submitted as separate claims ? one for the mom and one for the
baby ? and you will receive two separate Statements of Remittance (SOR).
For mom/well-baby claims, payment details will show on the mom?s SOR, as
shown in the examples below. There will
be no payment information on the well-baby?s SOR. Sick-baby dates of service
will pay at the contracted rate, and the
payment details will be on the baby?s SOR.*
Current state (prior to November 1, 2013):
Claim ID
DRG
Rev code
Billed charges
Payment
Comments
11111
765
120
15,000
5,000
Mom delivery line; line will pay
11111
765
170
4,000
0
Well-baby line; line will not pay
Total
19,000
5,000
Future state (on or after to November 1, 2013):
Claim ID
DRG
Rev code
Billed charges
Payment
Comments
11111
765
120
15,000
5,000
Mom delivery line; line will pay
Claim ID
DRG
Rev code
Billed charges
Payment
Comments
22222
795
170
4,000
0
Baby claim; line will not pay if mom is inpatient
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